What Did We Learn from the Ebola Scare?

It’s been over three years since the Ebola scare in the United States. How has it impacted infection control?

With today’s rapid news cycle, time seems to move faster than ever before. It’s hard to believe more than three years have passed since the Ebola virus disease (known commonly as “Ebola”) came to the United States, creating weeks of uncertainty both in society and the healthcare community.

The virus’ presence in the United States was limited to a six-week period (from the time the first patient arrived in the country until the last person was released from the hospital.) Today, Ebola is a distant memory for many Americans—but the healthcare community, particularly infection control professionals, haven’t forgotten the lessons of those tense times.

When the first Ebola patient arrived in the United States at Texas Health Presbyterian Hospital in Dallas, infection prevention professionals had varying opinions on the levels of preparation and resources necessary to deal with Ebola in the United States. While few were willing to go on record at the time, those professionals who felt the reaction to Ebola was exaggerated were somewhat vindicated, as the virus’ presence in the United States never reached epidemic or even extended ‘outbreak’ levels. Ebola’s presence in the United States was confined to:

Thomas Eric Duncan, a 45-year-old Liberian national visiting the United States;

two nurses who treated the man mentioned above;

a New York City physician who had just returned from treating patients with Ebola in Guinea, a West African nation

Mr. Duncan would pass away on October 8, 2014, the only Ebola-related fatality recorded in the United States. Before his death, controversy ensued over whether Duncan knew he had been exposed to Ebola at home in Liberia.

Robert Emery, a professor of Occupational Health with the University of Texas Health Science Center in Houston, says one lasting lesson of the Ebola saga was the importance of establishing a travel history in patients.

“Clinics are very attuned to making sure certain protocols are in place—but they haven’t discussed travel history with patients,” said Emery. “Once you establish the baseline signs and symptoms of a condition, travel history can be the next indication of whether you need to isolate the patient and get them to a higher level of care.”

“When the patient arrived in Dallas, it was clear he’d been to West Africa, and he was exhibiting symptoms of a viral hemorrhagic illness,” said Phenelle Segal, RN, CIC, founder and president of Infection Control Consulting Services. “They didn’t have bad practices, but there was an issue in communication. They didn’t initially realize they were dealing with Ebola.”

Perhaps the main issue was the level of resources—fiscal and human—invested in treating Ebola that would otherwise have been used in day-to-day programs that would have had a much greater impact on ongoing patient safety.

“We can’t downplay the fact that Ebola was serious, and we needed to do something,” explained Segal. “But maybe some of the measures were a little drastic.”

For example, hospitals in rural areas would redirect their professionals away from their day-to-day job duties to devote time to Ebola readiness. Some of these facilities designated entire sections of their small facilities for treatment of patients with Ebola—going so far as to create specialized, isolated entrances for such patients. The likelihood of such facilities ever coming into contact with an Ebola case was minuscule, as it was well known that large, urban-based medical centers were best equipped to treat potentially infected patients.

Obviously, infection prevention professionals are grateful that Ebola was contained in the United States before it could become a major public health concern. No one would categorize the reaction to Ebola as a failure, and most hesitate to even use the word “overreaction.”

“It was obviously critical to put Ebola prevention practices into place,” Segal summarized, “but it happened at the expense of continuing with our regular infection control practices, and it takes time to get back to that place.

“But I think we are right where we should be from that standpoint. No one’s even talking about Ebola any longer.”